摘要
目的 探讨乌司他丁对幕上肿瘤切除术患者血清肿瘤坏死因子（TNF）-α、基质金属蛋白酶（MMP）-9和基质金属蛋白酶组织抑制剂（TIMP）-1的影响。方法 择期行幕上肿瘤切除术的患者纳入本研究,随机分为对照组（C组）和乌司他丁组（U组）。U组在手术开始前30 min内静脉输注乌司他丁6 000 U/kg,C组则静脉输注等容量生理盐水。分别于麻醉诱导前10 min（T0）、剪硬膜即刻（T_1）、术毕（T_2）、术后24 h（T_3）和术后72 h（T_4）检测血清TNF-α、MMP-9和TIMP-1浓度。记录术后第1、3天头痛、恶心及呕吐评分,患者ICU停留时间和术后住院时间。结果 50例患者纳入本研究,每组25例。与_T0比较,C组T_2、T_3时点血清TNF-α浓度明显升高（P〈0.05）。2组T1时点血清MMP-9浓度均较T0明显升高,U组T3时点血清MMP-9浓度明显降低,2组T1~T4血清TIMP-1浓度均明显升高（P均〈0.05）。与C组比较,U组T2、T3时点血清TNF-α浓度及T3时点血清MMP-9浓度明显降低（P均〈0.05）,T_1、T_3时点血清TIMP-1浓度明显升高（P〈0.05）。与C组比较,U组患者术后第1天呕吐评分降低（P〈0.05）。结论 乌司他丁能够降低神经外科患者术后血清TNF-α浓度,降低术后MMP-9水平,可能具有一定的神经保护作用。
Objective To investigate ulinastatin （UTI） treatment on serum tumor necrosis factor （TNF）-α, matrix metalloproteinase （MMP）-9 and tissue inhibitor of metalloproteinase （TIMP）-1 in patients undergoing supratentorial neo- plasms surgery. Methods The patients undergoing elective supratentorial neoplasms surgery were randomized into the control group and the UTI group. UTI 6 000 U/kg was administrated with infusion at 30 min before operation in the UTI group. Headache, nausea and vomiting score for the period of 24 h and 72 h postoperatively were assessed. Serum TNF-α, MMP-9 and TIMP- 1 concentrations were measured pre-and postoperatively. The length of ICU stay and postoperative days were recorded. Results Fifty patients were enrolled into the study, 25 cases were in each group. Vomiting score at 24 h postoperative in the UTI group was lower than the control group （P 〈 0.05）. Compare to the baseline value, serum TNF-α concentration at the end of operation and 24 h postoperative was higher in the control group（P 〈 0.05）, the concen- tration of MMP-9 at the end of operation was higher in both groups （P 〈 0.05）, serum MMP-9 concentration at 24 h post- operative was lower in the UTI group （P 〈 0.05）, serum TIMP-1 concentration at T1-4 was higher in both groups （P 〈 0.05）. TIMP- 1 concentration at postoperative 1 day was higher in UTI group than the control group （P 〈 0.05）. The con- centration of TNF-α was lower in the UTI group than the control group （P 〈 0.05）. Conclusion UTI treatment is effec- tive for attenuation surgical injury in patients undergoing supratentorial neoplasms surgery. The beneficial effects may be associated with reduction in inflammation responses and MMP-9 levels in the early postoperative period.
出处
《北京医学》
CAS
2016年第3期233-236,共4页
Beijing Medical Journal
基金
北京市215高层次卫生技术人才学术带头人计划(008-0027)
